Weight loss severity and functional decline among the oldest old in a middle-income country: The FIBRA study longitudinal findings.


Journal

Clinical nutrition ESPEN
ISSN: 2405-4577
Titre abrégé: Clin Nutr ESPEN
Pays: England
ID NLM: 101654592

Informations de publication

Date de publication:
02 2023
Historique:
received: 10 06 2022
revised: 09 11 2022
accepted: 04 12 2022
entrez: 19 1 2023
pubmed: 20 1 2023
medline: 24 1 2023
Statut: ppublish

Résumé

Nutritional status is a key modifiable risk factor associated with disability, and further evidence suggests that weight change is also linked to this adverse outcome. Thus, this study aims to evaluate weight loss severity and functional decline in instrumental activities of daily living (IADL) in a seven-year period among a sample of Brazilian oldest-old adults. Longitudinal prospective study using data from the FIBRA study (Frailty in Older Brazilians), a population-based investigation carried out in 2008/2009, with follow-up data collected in 2016/2017 from participants who were 80 years and older in the follow-up in Campinas, Brazil. Of the 167 participants with complete data in 2016-2017, 16 had improved their functional status and were excluded, so the final sample was restricted to 151 participants who maintained or declined functional status. We considered functional decline when a subject had greater IADL dependencies at follow-up than baseline. Logistic regression was performed to assess the effect of weight loss, according to severity (moderate weight loss: 5-10% of body weight; severe weight loss >10%) in increasing the number of disabilities than the group with stable weight, controlling for covariates (gender, age, education, and morbidity). An alpha level of <5% was adopted. During the follow-up period, 60.3% of the participants kept stable weight, 21.8% had moderate weight loss, and 17.9% had severe weight loss. During the follow-up, only severe weight loss was associated with a higher risk of functional decline (OR = 2.74; p = 0.032). Severe weight loss was associated with functional decline. This finding reinforces the importance of early identification of weight loss among older adults.

Sections du résumé

BACKGROUND AND AIMS
Nutritional status is a key modifiable risk factor associated with disability, and further evidence suggests that weight change is also linked to this adverse outcome. Thus, this study aims to evaluate weight loss severity and functional decline in instrumental activities of daily living (IADL) in a seven-year period among a sample of Brazilian oldest-old adults.
METHODS
Longitudinal prospective study using data from the FIBRA study (Frailty in Older Brazilians), a population-based investigation carried out in 2008/2009, with follow-up data collected in 2016/2017 from participants who were 80 years and older in the follow-up in Campinas, Brazil. Of the 167 participants with complete data in 2016-2017, 16 had improved their functional status and were excluded, so the final sample was restricted to 151 participants who maintained or declined functional status. We considered functional decline when a subject had greater IADL dependencies at follow-up than baseline. Logistic regression was performed to assess the effect of weight loss, according to severity (moderate weight loss: 5-10% of body weight; severe weight loss >10%) in increasing the number of disabilities than the group with stable weight, controlling for covariates (gender, age, education, and morbidity). An alpha level of <5% was adopted.
RESULTS
During the follow-up period, 60.3% of the participants kept stable weight, 21.8% had moderate weight loss, and 17.9% had severe weight loss. During the follow-up, only severe weight loss was associated with a higher risk of functional decline (OR = 2.74; p = 0.032).
CONCLUSIONS
Severe weight loss was associated with functional decline. This finding reinforces the importance of early identification of weight loss among older adults.

Identifiants

pubmed: 36657910
pii: S2405-4577(22)01418-8
doi: 10.1016/j.clnesp.2022.12.008
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

170-174

Informations de copyright

Copyright © 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no competing interests.

Auteurs

Ligiana P Corona (LP)

Faculty of Applied Sciences, State University of Campinas (UNICAMP), R. Pedro Zaccaria, 1300 - 13484-35, Limeira, SP, Brazil. Electronic address: licorona@unicamp.br.

Flavia C D Andrade (FCD)

School of Social Work, University of Illinois at Urbana-Champaign, 1010 W. Nevada St., Office 2107, Urbana, IL, USA.

Flavia S A Borim (FSA)

Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Tessália Vieira de Camargo, 126 - 13083-887, Campinas, SP, Brazil.

Ivan Aprahamian (I)

Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Jundiaí Medical School (FMJ), R. Francisco Teles, 250 - 13202-550, Jundiaí, SP, Brazil.

André Fattori (A)

Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Tessália Vieira de Camargo, 126 - 13083-887, Campinas, SP, Brazil.

Matteo Cesari (M)

Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università di Milano, Via Festa Del Perdono, 7, 20122, Milano, MI, Italy.

Anita L Neri (AL)

Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Tessália Vieira de Camargo, 126 - 13083-887, Campinas, SP, Brazil.

Monica S Yassuda (MS)

School of Arts, Sciences and Humanities (EACH), University of Sao Paulo (USP), Rua Arlindo Béttio, 1000 - 03828-000, São Paulo, SP, Brazil.

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